| NPI | 1184077992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 55708) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01087147A) |
| 207R00000X Internal Medicine (Licence: OH 57.027612) | |
| Enumeration Date | 2016-07-16 |
| Last Update Date | 2022-11-15 |