| NPI | 1609398999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WA MD615645599) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: SD 15437) |
| Enumeration Date | 2017-07-09 |
| Last Update Date | 2024-09-07 |