| NPI | 1841622008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: MO 2019043159) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI (4301103182) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL TRN28534) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2024-09-27 |