| NPI | 1568404622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX K0175) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX K0175) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-01-22 |