| NPI | 1851398622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.013565) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 013565) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2017-04-19 |