| NPI | 1487653184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 35056361) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.056361) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2015-04-20 |