| NPI | 1679990527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX T5371) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV LL2494) |
| 207R00000X Internal Medicine (Licence: NV 17055) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-11-11 |