| NPI | 1750343620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA C53019) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 38913) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2015-05-11 |