| NPI | 1902293749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AZ 77030) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: UT 10102120-1205) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2025-07-22 |