| NPI | 1235332974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101244197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101244197) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0101244197) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2012-01-18 |