| NPI | 1205298189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX S1607) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S1607) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2026-08-05 |