| NPI | 1912296401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CT 52975) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 52975) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 52975) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2019-07-03 |