| NPI | 1720057862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 28708) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 28708) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35077864S) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35077864S) | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: KY 28708) | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: OH 35077864S) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2013-10-24 |