| NPI | 1326206632 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AL 34106) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 97869876789876978697) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 34106) | |
| Enumeration Date | 2008-05-23 | 
| Last Update Date | 2025-03-19 |