| NPI | 1740498732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 642326403) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 185528) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-03-01 |