| NPI | 1679733646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA C169584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 15456) |
| 207R00000X Internal Medicine (Licence: MA 232553) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2020-10-20 |