| NPI | 1942259114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 25813) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 30837) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101255193) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2016-11-28 |