| NPI | 1194993147 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD61605779)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087556)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 28008)  | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NE 28008)  | |
| Enumeration Date | 2008-02-12 | 
| Last Update Date | 2025-04-07 |