| NPI | 1285922054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 259997) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 248870) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 259997) | |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2023-11-03 |