| NPI | 1992900849 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PR 14358) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PR 14358) | 
| Enumeration Date | 2007-06-20 | 
| Last Update Date | 2021-03-09 |