| NPI | 1679532287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WI 68488) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA39764) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2019-09-16 |