| NPI | 1538161187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301066050) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301066050) |
| 2471V0106X Radiologic Technologist, Vascular-Interventional Technology (Licence: MI 4301066050) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2023-03-07 |