| NPI | 1679577597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX S2912) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301077499) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35079630T) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301077499) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2020-10-28 |