| NPI | 1679186894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.148491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.249546) |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2025-04-09 |