| NPI | 1629397674 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A118644) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A118644) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A118644) | |
| Enumeration Date | 2010-05-28 | 
| Last Update Date | 2023-03-14 |