| NPI | 1619071842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: MD D23805) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: DC 13973) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2021-07-19 |