| NPI | 1972613487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 51912) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AR E7468) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO R3N07) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: ND LT15153) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-10-01 |