| 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: NC 2024-00449) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL 26825) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 51972) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2024-10-23 |