| NPI | 1043586159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX S0869) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX S0862) |
| 2086S0129X Surgery Vascular Surgery (Licence: TX S0862) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2023-12-20 |