| NPI | 1629053996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 34291) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: IA 34291) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME95505) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301110049) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2026-06-25 |