| NPI | 1518957919 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-078989)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35-078989)  | 
| Enumeration Date | 2005-10-26 | 
| Last Update Date | 2024-08-01 |