| NPI | 1033316948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME107013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN11520) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2015-09-04 |