| NPI | 1659363141 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MT 48734)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NV 10524)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A84369)  | |
| Enumeration Date | 2005-08-19 | 
| Last Update Date | 2016-11-28 |