| NPI | 1124098819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 34008512) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MS 25408) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2018-03-17 |