| NPI | 1588186456 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: UT 13320150-1205) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA R-11718) | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10059587) | |
| Enumeration Date | 2017-07-12 | 
| Last Update Date | 2024-08-27 |