| NPI | 1609843879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL ME127303) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WI 20510) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2022-01-25 |