| NPI | 1558895052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 72555) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 72555) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CT 72555) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-07-14 |