| NPI | 1346484664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA md460742) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301100159) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.127547) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2019-04-04 |