| NPI | 1316023211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX m7765) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 00026447) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-04-13 |