| NPI | 1629366984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME166209) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WY 11471A) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2020036967) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2024-07-10 |