| NPI | 1730503657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SD 15475) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 64846-20) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MT 140094) | |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2025-01-16 |