| NPI | 1164807087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2023004697) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP552) |
| 207R00000X Internal Medicine (Licence: MI 4301107551) | |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2023-07-31 |