| NPI | 1548424039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2008-01216) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2008-01216) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2014-01-27 |