| NPI | 1063651156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX P7307) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 14085) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN MD44575) | |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2013-12-23 |