| NPI | 1194229336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX U9389) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102205803) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2025-07-03 |