| NPI | 1477817823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME147338) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MT MED-PHYS-LIC-175204) |
| Enumeration Date | 2012-06-30 |
| Last Update Date | 2026-09-06 |