| NPI | 1912027582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 73717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 73717) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2011-04-12 |