| NPI | 1194993147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: NE 28008) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NE 28008) |
| 207R00000X Internal Medicine (Licence: MI 4301087556) | |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2020-04-02 |