| NPI | 1629397393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME132420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 45823) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME132420) | |
| 208D00000X General Practice (Licence: KY R2412) | |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2018-03-17 |