| NPI | 1265697957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A103682) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P1311) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX P1311) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2021-08-10 |