| NPI | 1548791460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2024004500) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2024004500) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 05-49558) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KS 05-49558) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2025-09-18 |