| NPI | 1285071357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 34.013017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3622) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-03-10 |