| NPI | 1639480221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5101018878) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101018878) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2016-09-27 |