| NPI | 1902240716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX T1587) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 29951) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OK 29951) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2025-01-15 |