| NPI | 1770664716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX 47191) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OK 30455) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-12-02 |