| NPI | 1962408344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA MD026928E) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD026928E) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35060116S) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35060116) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2015-09-16 |