| NPI | 1578615480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD 435510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35089082) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A 95258) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2021-11-29 |