| NPI | 1962887059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A172807) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.025760) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2025-07-09 |