| NPI | 1730175241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GU M1918) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 141313) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: NY 141313) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2016-08-07 |