| NPI | 1629207477 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2016023781)  | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35129185)  | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: IL 036143069)  | |
| Enumeration Date | 2009-07-14 | 
| Last Update Date | 2022-04-01 |