| NPI | 1700061736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N7159) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N7159) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD214-0864) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2016-02-26 |