| NPI | 1629166103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 30574) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SC 30574) |
| 207R00000X Internal Medicine (Licence: NC 201001296) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-05-12 |