| NPI | 1710307384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: UT 12192553-1205) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: IA R-11922) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-07-02 |