| NPI | 1962644310 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MD D92520)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY C1378)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2015008626)  | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0101278702)  | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KS 0447213)  | |
| Enumeration Date | 2009-04-01 | 
| Last Update Date | 2023-10-03 |