| NPI | 1104855329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA Pending) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME122885) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME122885) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2016-04-26 |