| NPI | 1285253062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 34.015922) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5101027249) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2026-06-18 |