| NPI | 1639481989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.098819) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 20592) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-04-19 |