| NPI | 1023403409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX T6654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T6654) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T6654) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-07-28 |