| NPI | 1912987264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N2544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 47928) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX N2544) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2013-04-08 |