| NPI | 1164738449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: ND 14525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE TEP 6390) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2020-04-07 |