| NPI | 1730611096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.155876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 97235) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2026-06-12 |