| NPI | 1952660532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: DE C1-0013743) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: PA MD463771) |
| 207R00000X Internal Medicine (Licence: NY 272931-1) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2020-06-12 |