| NPI | 1013082098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: VT 042-0006395) |
| Additional Taxonomies | 174400000X Specialist (Licence: VT 042-0006395) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2019-01-16 |