| NPI | 1114920998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: LA 09770R) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 09770R) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-06-25 |