| NPI | 1649419029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 53044) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N0702) |
| 207R00000X Internal Medicine (Licence: WA MD00049232) | |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2016-10-27 |