| NPI | 1609294131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 50127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.024365) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 66656) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2025-05-27 |