| NPI | 1275055915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX U9246) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2018-0729) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10059583) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.254400) | |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2025-08-29 |