| NPI | 1073585188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N4356) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2002010420) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2021-09-14 |