| NPI | 1619964095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA C42324) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C42324) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2013-11-12 |