| NPI | 1306104765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX R9719) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 52345) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX R9719) | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2019-06-25 |