| NPI | 1942281944 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 19806) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL 19806) | 
| Enumeration Date | 2005-11-08 | 
| Last Update Date | 2009-11-23 |