| NPI | 1912427345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX U6313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U6313) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX U6313) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301112472) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2024-07-10 |