| NPI | 1639130495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2011-0196) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 39193) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 47180) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2014-02-02 |