| NPI | 1720106685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 44104) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35089064) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 207RC0000X) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2024-01-29 |