| NPI | 1730386004 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2008011529) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34009014) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 05-35719) | |
| Enumeration Date | 2007-06-29 | 
| Last Update Date | 2021-01-04 |