| NPI | 1922521012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AL 46446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 312694) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA MD491578) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2025-12-08 |