| NPI | 1366444556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 35-10-0203) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.100203) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2013-11-20 |