| NPI | 1912975608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 35596) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 35596) |
| 207R00000X Internal Medicine (Licence: OH 35069776S) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 35596) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35069776S) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35069776S) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2022-10-24 |