| NPI | 1871584433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: KY 37822) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: KY 37822) |
| 207R00000X Internal Medicine (Licence: KY 37822) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2015-04-15 |