| NPI | 1396963617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 122615) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101241635) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2018-03-17 |