| NPI | 1962508325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A76728) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A76728) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M1639) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2021-01-15 |