| NPI | 1568749224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R9266) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-17699) |
| 207R00000X Internal Medicine (Licence: CA A117343) | |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2022-01-04 |