| NPI | 1508030024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.088625)  | 
| Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: OH 35.088625)  | 
| Enumeration Date | 2008-04-16 | 
| Last Update Date | 2010-02-27 |