| NPI | 1710185335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME122113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 14736) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME122113) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2024-05-15 |