| NPI | 1922456219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX U2766) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-08968) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2023-09-16 |