| NPI | 1811260607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MN 57953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 0089) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2018-07-02 |