| NPI | 1518461755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301513832) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.245720) |
| 207R00000X Internal Medicine (Licence: WV 30413) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-04-12 |