| NPI | 1528066230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME23062) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 23062) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-06-03 |