| NPI | 1376752048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX Q0486) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 33580) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2022-01-24 |