| NPI | 1265521470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME102636) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME102636) |
| 207R00000X Internal Medicine (Licence: FL TRN10082) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-12-16 |