| NPI | 1518961564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD033792E) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 221030-1) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-055020) | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2020-09-11 |