Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 35.138344 | OH |
NPI | 1063655165 |
---|---|
Provider Name | Muhammad Tipu Rishi |
First Address | Hamilton, OH 45013-2772 |
Second Address | Kettering, OH 45429-1221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2009 |
Last Update Date | 17/12/2020 |