| NPI | 1104073766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301091996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301091996) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AZ 77254) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2025-05-23 |