| NPI | 1790078079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WI 81449-20) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX FB7690515) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX R7950) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2025-03-12 |