| NPI | 1649526716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 51984) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P27641) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2019-05-24 |