| NPI | 1164406906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: OK 28265) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 043057) |
| 207R00000X Internal Medicine (Licence: OH 35.087849) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2014-03-03 |