| NPI | 1730103961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL ME84837) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35084872) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: AZ 37228) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-04-03 |