| NPI | 1831610302 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA 230064679)  | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA 230064679)  | 
| Enumeration Date | 2017-07-05 | 
| Last Update Date | 2024-07-24 |