| NPI | 1548376601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: HI Pending) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY 8644A) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD60320133) | |
| 207R00000X Internal Medicine (Licence: NH RT-1503) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2021-08-26 |