| NPI | 1811954530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G10507) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G10507) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2015-02-03 |