| NPI | 1770749392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME133681) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 235682) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2024-04-23 |