| NPI | 1639510753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: TN 71580) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 71580) |
| 207R00000X Internal Medicine (Licence: TN 71580) | |
| 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 | 2025-03-06 |