| NPI | 1801150214 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA 61496230) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD218304) | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AR E-15427) | |
| Enumeration Date | 2012-06-29 | 
| Last Update Date | 2025-06-09 |