| NPI | 1699821520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX T4742) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 67202) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0101260052) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WI 72786) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2025-10-07 |