| NPI | 1558556001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX N0781) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N0781) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX N0781) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2014-09-29 |