| NPI | 1972130409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V0124) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX BP10077031) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-06-18 |