| NPI | 1215979216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301097614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-083670) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-03-05 |