| NPI | 1861848749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX 47666) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267127) | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX 47361) | |
| Enumeration Date | 2016-05-10 | 
| Last Update Date | 2022-12-01 |