| NPI | 1518012616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME104343) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX L9451) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2014-07-03 |