| NPI | 1619957321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME21464) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME0021464) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME21464) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2021-09-07 |