| NPI | 1740642040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL 175970) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 175970) |
| 207R00000X Internal Medicine (Licence: TN 59500) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-09-05 |