| NPI | 1114313061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2023013135) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 61125) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-08-28 |