| NPI | 1952562795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: SC MD39876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 066210) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2017-02-26 |