| NPI | 1831372135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 60494103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 246962) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 246962) | |
| 207R00000X Internal Medicine (Licence: WA 60494103) | |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2015-04-15 |