| NPI | 1639160823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: LA 023975) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX M2326) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2021-01-05 |