| NPI | 1477937696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: MN 82055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD16240) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2026-06-14 |