| NPI | 1104898816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 40943) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35090194) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 40943) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35090194) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2018-03-17 |