| NPI | 1164414017 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: UT 187176-1205) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 187176-1205) | 
| Enumeration Date | 2005-08-17 | 
| Last Update Date | 2015-01-20 |