| NPI | 1770566325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 13708) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: AZ 13708) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: CA G54154) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2020-09-03 |