| NPI | 1184840506 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 46010) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.010937) | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AZ 46010) | |
| Enumeration Date | 2007-04-17 | 
| Last Update Date | 2025-08-05 |