| NPI | 1336379635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 35126749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 53134) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: OH 35126749) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2017-08-09 |