| NPI | 1679923254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME162979) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME162979) |
| 207R00000X Internal Medicine (Licence: RI LP03806) | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2023-09-06 |