| NPI | 1760421564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: KY 36463) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: KY 36463) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-03-18 |