| NPI | 1932204518 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0046554) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME0046554) | 
| Enumeration Date | 2006-09-14 | 
| Last Update Date | 2021-08-06 |