| NPI | 1861614737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OK 28995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 946353) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-01-06 |