| NPI | 1912393901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX T0686) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX T0686) |
| 207R00000X Internal Medicine (Licence: TX T0686) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2025-08-05 |