| NPI | 1962558056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX F1884) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX F1884) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2024-08-23 |