| NPI | 1396916730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2011-00458) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01061867A) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2017-01-11 |