| NPI | 1619974987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 33001) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-03-9624) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35039624) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2023-03-24 |