| NPI | 1720365406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX P3259) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P3259) |
| 207R00000X Internal Medicine (Licence: TX BP10036690) | |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2022-10-04 |