| NPI | 1538591912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR MD205190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT204670) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2021-08-19 |