| NPI | 1114927928 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX L6265) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX L6265) | 
| Enumeration Date | 2005-07-22 | 
| Last Update Date | 2009-09-30 |