| NPI | 1467080713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.147902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME174477) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME174477) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME174477) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-06-28 |