| NPI | 1013578699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 67983) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57247681) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2023-08-09 |