NPI | 1063906410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0101285627) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT2166331) |
Enumeration Date | 2018-06-19 |
Last Update Date | 2025-06-09 |