| NPI | 1215906979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N6378) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35-078159) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2022-01-31 |