| NPI | 1902219876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PR 23151) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PR 23151) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PR 23151) | |
| Enumeration Date | 2014-06-08 |
| Last Update Date | 2023-06-28 |