| NPI | 1316914435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME0033368) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 33368) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2010-02-23 |