| NPI | 1578024840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301516897) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301516897) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301516897) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2026-08-26 |