| NPI | 1972504777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD034809E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD034809E) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: PA MD034809E) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2021-04-15 |