| NPI | 1720084049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G24462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G24462) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2016-08-30 |