| NPI | 1811150881 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301097629)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055096)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301097629)  | |
| Enumeration Date | 2008-07-09 | 
| Last Update Date | 2015-06-19 |