| NPI | 1407843287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX L2043) |
| Additional Taxonomies | 2086S0129X (Licence: TX L2043) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2018-07-02 |