| NPI | 1558908756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U2327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 332747) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 332747) | |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2024-09-20 |