| NPI | 1720065188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NM MD2019-0764) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 32942) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AL 14308) | |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: AZ 32942) | |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: NM MD2019-0764) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2022-09-07 |