| NPI | 1790788693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA G65731) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G65731) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA G65731) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2020-12-04 |