| NPI | 1174784904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX P5215) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 204576) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-08-28 |