| NPI | 1225320609 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35823512)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036134813)  | 
| Enumeration Date | 2011-05-04 | 
| Last Update Date | 2022-01-25 |