| NPI | 1700804192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: RI MD 10730) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 037829) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |