| NPI | 1801186663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX S3621) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.120054) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX S3621) | |
| 282N00000X General Acute Care Hospital (Licence: OH 57.017377) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110464) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2022-12-14 |