| NPI | 1689625113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME113924) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IN 01062167A) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL ME113924) | |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: FL ME113924) | |
| 261QU0200X Clinic/Center Urgent Care (Licence: FL ME113924) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2024-06-13 |