| NPI | 1710968060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VI 1191) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: GA GA68903) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME73855) | |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2022-08-04 |