| NPI | 1790988947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: MO 2012016488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD431654) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2014-03-13 |