| NPI | 1972165785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX W6773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073924) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2026-08-17 |