| NPI | 1255852687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 35.150721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271621) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2024-04-29 |