| NPI | 1770875338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX T6200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T6200) |
| 207R00000X Internal Medicine (Licence: PA MT199159) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD453930) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 308992) | |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2022-04-29 |