| NPI | 1225295132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N6926) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0031995) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-05-05 |