| NPI | 1740462522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PR 17470) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 17470) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2013-08-19 |