| NPI | 1073826814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.128702) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 40754) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2024-07-15 |