| NPI | 1265604524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.121496) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT186044) |
| 207R00000X Internal Medicine (Licence: PA MD4014) | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2013-07-23 |