| NPI | 1215972419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX H22261) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H22261) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2010-10-01 |