| NPI | 1225311095 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX V7100) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME150651) | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME150651) | |
| Enumeration Date | 2011-09-27 | 
| Last Update Date | 2025-06-14 |