| NPI | 1487397956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.153044) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 74600) |
| 207R00000X Internal Medicine (Licence: MN 32473) | |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2025-06-20 |