| NPI | 1235136425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 28522) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-03-4038) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2011-03-25 |