| NPI | 1891715769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX 98388) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX F9470) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA 98388) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-12-06 |