| NPI | 1558921189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA MD-51967) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.248517) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA R-12596) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2023-08-23 |