| NPI | 1083799365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 45497) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 45929) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME111239) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-07-12 |