| NPI | 1457563702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.093847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2006016915) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2014-07-02 |