| NPI | 1376528919 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35120477)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036111559)  | 
| Enumeration Date | 2005-12-07 | 
| Last Update Date | 2024-08-01 |