| NPI | 1730104993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N1750) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 44788-020) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY KY43702) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY KY43702) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-09-17 |