| NPI | 1821541442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX U4770) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A164481) |
| 207R00000X Internal Medicine (Licence: PA MT212195) | |
| 207R00000X Internal Medicine (Licence: NY 300505) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2023-09-18 |