| NPI | 1104302082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NC 2025-00207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8272) |
| 207R00000X Internal Medicine (Licence: IA R-12153) | |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2025-07-25 |