| NPI | 1508048158 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME101406)  | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: IN 01056048A)  | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2008003418)  | |
| Enumeration Date | 2007-12-05 | 
| Last Update Date | 2018-04-02 |