| NPI | 1962612408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WV 22159) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WV 22159) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-07-21 |