| NPI | 1033544135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: OH 35.120322) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.120322) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 35.120322) | |
| 282NC0060X General Acute Care Hospital Critical Access (Licence: OH 35.120322) | |
| Enumeration Date | 2013-09-07 |
| Last Update Date | 2016-05-11 |