| NPI | 1518217413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 04843) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 23964) |
| 207R00000X Internal Medicine (Licence: MS T2636) | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2020-12-04 |