| NPI | 1831550730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX T9046) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 52535) |
| Enumeration Date | 2016-03-19 |
| Last Update Date | 2022-10-27 |