| NPI | 1679571376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX K3460) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX K3460) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2023-10-25 |