| NPI | 1003115486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA 130311) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A130311) |
| 207R00000X Internal Medicine (Licence: CA A130311) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2026-05-26 |