| NPI | 1548522956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 10738461-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 182986) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2021-09-23 |