| NPI | 1629098413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX L7636) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L7636) |
| 207R00000X Internal Medicine (Licence: IA 35576) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-09-26 |