| NPI | 1821403775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX T0585) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 30720) |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2023-01-19 |