| NPI | 1710109509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX L3348) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX L3348) |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: CA C55905) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-02-15 |