| NPI | 1023007085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX L2101) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L2101) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NM 2002-0295) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2014-12-17 |