| NPI | 1669829974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME167355) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A185187) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2024-05-16 |