| NPI | 1558340034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G61809) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G61809) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2017-03-28 |