| NPI | 1346777638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.152972) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 341914) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2026-05-01 |