| NPI | 1922394899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 48386) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0060651) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CO DR.0060651) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 48386) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2018-12-14 |