| NPI | 1174752372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX Q9557) |
| Additional Taxonomies | 193200000X Multi-Specialty (Licence: TX Q9557) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2019-05-07 |