| NPI | 1679541163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 20196) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 20196) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35050795) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35050795) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2011-05-20 |