| NPI | 1720076334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WV WV15164) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: WV WV15164) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2016-02-26 |