| NPI | 1770841546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY TP460) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R2897) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2020-12-02 |