| NPI | 1568892586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA md61036214) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MN 63287) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2020-04-24 |