| NPI | 1609920859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: OH 35127819) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OR MD166969) |
| 207R00000X Internal Medicine (Licence: OR MD166969) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-05-23 |