| NPI | 1427554856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME172739) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.140337) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2025-06-19 |