| NPI | 1063906410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0101285627) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT2166331) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2025-06-09 |