| NPI | 1962408526 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR MD167662) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD167662) | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX T0899) | |
| Enumeration Date | 2005-06-28 | 
| Last Update Date | 2025-08-25 |