| NPI | 1093077075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 310311) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U6168) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX U6168) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2023-10-03 |