| NPI | 1306836861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-075446) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35-075446A) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2012-03-27 |