| NPI | 1003811563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: VA 0101047289) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WV 16632) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2021-09-14 |