| NPI | 1376934059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD61210673) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX Q8376) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101281686) | |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2025-07-07 |