| NPI | 1609863505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OK 16990) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 16990) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2013-10-30 |