| NPI | 1528191053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 15307) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CO 15307) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO 15307) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |