| NPI | 1255544839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX M7204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M7204) |
| 207R00000X Internal Medicine (Licence: PA MT185082) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2024-08-27 |