| NPI | 1295939262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N6695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 2866626-S150) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2010-07-29 |