| NPI | 1912097627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL ME107389) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 39894) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-02-05 |