| NPI | 1104956119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX M3018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M3018) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M3018) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2024-12-19 |