| NPI | 1184621179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 31090) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-06-5715-S) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2021-07-16 |