| NPI | 1598091092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N9337) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10034824) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35132003) | |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2025-04-02 |