| NPI | 1417367541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD61309233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10049210) |
| 208000000X Pediatrics (Licence: TX BP10049210) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2022-09-27 |