| NPI | 1114979168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NM MD2023-1379) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J9121) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX J9121) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2025-04-22 |