| NPI | 1265798763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R7048) | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: GA 73778) | 
| Enumeration Date | 2012-04-09 | 
| Last Update Date | 2025-06-09 |