| NPI | 1053675157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2022010834) | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AL MD.38128) | 
| Enumeration Date | 2012-07-03 | 
| Last Update Date | 2022-07-18 |