| NPI | 1760480214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME21229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0021229) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2016-02-27 |