| NPI | 1891899084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX J1212) |
| Additional Taxonomies | 246W00000X Technician, Cardiology (Licence: TX J1212) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2011-12-19 |