| NPI | 1376782300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX M4096) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M4096) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M4096) | |
| Enumeration Date | 2009-02-15 |
| Last Update Date | 2011-10-07 |