| NPI | 1477999050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 312468) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R0989) |
| 207R00000X Internal Medicine (Licence: NM 312468) | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2021-08-20 |