| NPI | 1578900619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME143891) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN19046) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2023-01-11 |