| NPI | 1902298219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: CA A183097) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX T4907) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2025-08-21 |