| NPI | 1720320658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 34.014050) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02004692A) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2023-04-19 |