| NPI | 1811074008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A-21261) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A21261) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A21261) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A-21261) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-11-22 |