| NPI | 1184967937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R1168) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R1168) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101270896) | |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2024-03-21 |