| NPI | 1255562138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX S9388) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-015856) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2022-09-06 |