| NPI | 1861499808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX P8456) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 10976R) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2020-04-15 |