| NPI | 1811956659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 21501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 21501) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WV 21501) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2021-11-23 |