| NPI | 1124016787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: IA 35154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 35154) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 35154) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2007-12-04 |