| NPI | 1164614731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD60218278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH au2866626-s235) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2021-04-01 |