| NPI | 1417161126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX S3485) |
| Additional Taxonomies | 2086S0129X (Licence: TX s3485) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2025-09-24 |