| NPI | 1114065547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301119316) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-0836040) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.202262) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2016-01051) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301119316) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2023-03-01 |