| NPI | 1427581875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX U4579) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: NJ 25MA11124000) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 34420) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-09-07 |