| NPI | 1922483841 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL OS13153)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS13153)  | 
| Enumeration Date | 2015-07-21 | 
| Last Update Date | 2020-04-06 |