| NPI | 1629042973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 028112) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 028112) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2013-04-16 |