| NPI | 1154325702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA G71845) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G71845) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA G71845) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2017-12-04 |