| NPI | 1407174923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS13336) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO1849) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2016-02-25 |