| NPI | 1588950075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.139684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301098687) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 71638) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2023-11-03 |