| NPI | 1104357631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: KS 04-49781) |
| Additional Taxonomies | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: WI 82039-20) |
| 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: MO 2024033053) | |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2024-08-19 |