| NPI | 1710151204 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 58.002465) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AR E-8841) | 
| Enumeration Date | 2008-04-16 | 
| Last Update Date | 2014-12-11 |