| NPI | 1780834143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 15184) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 237942) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2012-03-29 |