| NPI | 1811254857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX P8012) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX P8012) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2019-07-12 |