| NPI | 1265759328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 266166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.055623) |
| 207R00000X Internal Medicine (Licence: TX P2411) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2020-08-04 |