| 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 |