| NPI | 1063875102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX S4083) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX S4083) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2024-01-30 |