| NPI | 1609840990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 57346) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 57346) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 57346) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-08 |