| NPI | 1942519319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX R9755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-058132) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R9755) | |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2020-10-26 |