| NPI | 1689909418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX Q8562) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.010361) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2019-03-27 |