| NPI | 1710944939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WV 18376) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 18376) |
| 207R00000X Internal Medicine (Licence: WV 18376) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2022-04-18 |