| NPI | 1629141411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME19379) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL 17257) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2015-07-20 |