| NPI | 1063790467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD61154867) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301098684) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2021-10-14 |