| NPI | 1154709772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.132956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.026102) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2026-05-04 |