| NPI | 1144666025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R4556) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R4556) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX R4556) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301102892) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2024-05-20 |