| NPI | 1114281672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX U6003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD18591) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: RI MD18591) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2026-02-25 |