| NPI | 1356346183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD11311) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2017-01-05 |