| NPI | 1821192501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME54054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 117611) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 117611) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2019-09-12 |