| NPI | 1760656151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01073926A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-012978) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2021-12-17 |