| NPI | 1760575278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX M8595) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-108300) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M8595) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-05-08 |