| NPI | 1285012070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R3778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10054299) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2021-09-01 |