NPI | 1639510753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 71580) |
Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: KY TP792) |
282N00000X General Acute Care Hospital (Licence: MI 4301102762) | |
Enumeration Date | 2013-07-17 |
Last Update Date | 2024-07-03 |