| NPI | 1225259435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX P3016) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-051331) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX P3016) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2017-03-02 |