| NPI | 1790212850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX T7680) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX T7680) |
| 207R00000X Internal Medicine (Licence: TX BP10059680) | |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2025-03-24 |