| NPI | 1639135973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 36977) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35063530) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2025-12-18 |