| NPI | 1912139411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: OR DO202983) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA OS016108) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MB09228000) | |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: TN 3152) | |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: VA 0102204734) | |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2021-05-11 |