| NPI | 1215060140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35062485S) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD040586E) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 14695) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-05-12 |