| NPI | 1730129578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 15124) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.083882) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-06-05 |