| NPI | 1114923778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35044845M) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD031529E) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 12331) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2023-06-19 |