| NPI | 1912197328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: MD D72708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.011516) |
| 208000000X Pediatrics (Licence: OH 57.011516) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2019-09-16 |