| NPI | 1407032634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N9924) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX n9924) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: TX N9924) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N9924) | |
| 208D00000X General Practice (Licence: TX N9924) | |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2025-09-16 |