| NPI | 1871856492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL OS19614) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101020121) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2023-06-22 |