| NPI | 1891705745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301080801) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301080801) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2016-12-30 |