| NPI | 1750523684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WI 77847) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: IN 02006049A) |
| 208D00000X General Practice (Licence: WA OP 60100157) | |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: WI 22007) | |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: WI 22007-875) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2025-09-30 |