| NPI | 1235397779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 34.010986) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34010986) |
| 207R00000X Internal Medicine (Licence: MI 5101017437) | |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2022-01-25 |