| NPI | 1114917465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35065910) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD065190L) |
| 207R00000X Internal Medicine (Licence: OH 35065910) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2013-01-10 |