| NPI | 1710364377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX V3556) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 294792) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 294792) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX V3556) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2026-08-26 |