| NPI | 1932462140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V7818) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.129000) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX V7818) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: NY 281990) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2025-05-20 |