| NPI | 1609215276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: OH 34.013005) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116025995) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2020-10-26 |