| NPI | 1962674960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA C53713) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L9801) |
| 207R00000X Internal Medicine (Licence: CA C53713) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2010-11-30 |