| NPI | 1558367284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 4033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.008051) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2020-07-06 |