| NPI | 1396058095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A144982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT196099) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2020-12-15 |