| NPI | 1194004291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 282839) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY TP802) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2020-10-06 |