| NPI | 1174785695 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA 109332) | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA 109332) | 
| Enumeration Date | 2008-06-26 | 
| Last Update Date | 2021-01-18 |