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 |