| NPI | 1417953068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.095900) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101226323) |
| 207R00000X Internal Medicine (Licence: OH 35095900) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2015-02-25 |