| NPI | 1639397219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G63272) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G63272) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2010-11-08 |