| NPI | 1194766683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL FLME64999) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME0064999) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2018-08-16 |