| NPI | 1669490637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: SC 31062) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 11618) |
| 207R00000X Internal Medicine (Licence: SC 31062) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-05-24 |