| NPI | 1265955454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX U3998) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8093) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX BP10072214) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2023-05-31 |