| NPI | 1114925419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301512897) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NC 9900410) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SC 23018) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35.140660) | |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2025-05-16 |