| NPI | 1336243419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA C050117) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C050117) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA C050117) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2014-11-25 |