| NPI | 1366822801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: AZ 64400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R75123) |
| Enumeration Date | 2015-05-30 |
| Last Update Date | 2022-08-23 |