| NPI | 1609064880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A101434) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A101434) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A101434) | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A101434) | |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2022-11-21 |