| NPI | 1558444216 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NC 2020-00954)  | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MT MED-PHYS-LIC-10527)  | 
| Enumeration Date | 2006-10-23 | 
| Last Update Date | 2020-04-02 |