| NPI | 1396091104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX U2703) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 47929) |
| 208M00000X Hospitalist (Licence: KY 47929) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2025-07-21 |