| NPI | 1619096278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.093591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 49699) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2019-02-28 |