| NPI | 1134649205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.151114) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 29891) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2025-09-23 |