| NPI | 1912223603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: ND 16991) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: MN 61607) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2020-12-08 |