| NPI | 1669817987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: CA A167870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74126) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2020-07-28 |