| NPI | 1902085426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A117314) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A117314) |
| 207R00000X Internal Medicine (Licence: CA A117314) | |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2017-04-24 |