| NPI | 1184787509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME68576) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN14394) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35.067391) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2024-03-19 |