| NPI | 1679968960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WV 35760) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 321684) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX T6260) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101261450) | |
| 207R00000X Internal Medicine (Licence: VA 0101261450) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2026-01-22 |