| NPI | 1740269711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME139561) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35-07-8422) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-12-29 |