| NPI | 1124215249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL ME54349) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME54349) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |