| NPI | 1063456127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME 75658) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME 75658) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2011-03-16 |