| NPI | 1083655047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 39597) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY MD39597) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2011-12-27 |