| NPI | 1053706804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX U2951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME136524) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2023-12-11 |