| NPI | 1821434424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 149852-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT 149852-1205) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2013-05-22 |