| NPI | 1659759157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX R4720) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX R4720) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: TX R4720) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2023-11-02 |