| NPI | 1538509807 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.137449) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2013021028) | 
| Enumeration Date | 2013-07-01 | 
| Last Update Date | 2024-02-05 |