| NPI | 1003257999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX V3590) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX V3590) |
| 207R00000X Internal Medicine (Licence: TX V3590) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: OH 35.127080) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2025-09-29 |