| NPI | 1750734349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2018012746) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2016018404) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: GA 95623) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2023-06-21 |