| NPI | 1316974637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TN MD45417) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME87246) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2012-03-12 |