| NPI | 1386879054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.135126) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301095089) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2019-01-16 |