| NPI | 1265751788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 51304) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301096178) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX Q0251) | |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2020-10-14 |