| NPI | 1255315347 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301048135)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301048135)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35057974)  | |
| Enumeration Date | 2005-12-01 | 
| Last Update Date | 2014-01-13 |