| NPI | 1790714251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MT 6285) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT 6285) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD60556860) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2017-03-28 |