| NPI | 1710991575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 103899) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101250484) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35070871) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2025-09-16 |