| NPI | 1346458189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IL 036145522) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.010728) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2021-12-15 |