| NPI | 1104486463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: UT 14282007-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82822) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2026-07-22 |