| NPI | 1245610229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: MA 288607) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03507) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2021-06-24 |