| NPI | 1629293022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01074146A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57011476) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-09-03 |