| NPI | 1265797534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SC 91387) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL 26825) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 68066) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SD 18371) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NC 2024-00449) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 51972) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA IMLC.MD.70112833) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2026-03-30 |