| NPI | 1184685810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 36147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 36147) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WI 27453-020) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-11-14 |