| NPI | 1902246804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R6758) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 006154) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-04-23 |