| NPI | 1881993236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX P9081) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 6461) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2018-08-07 |