| NPI | 1053758490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA 70111006) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD204969) |
| 207R00000X Internal Medicine (Licence: NY 280378) | |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2026-06-10 |