| NPI | 1780649301 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35077759) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01059484A) | 
| Enumeration Date | 2006-04-18 | 
| Last Update Date | 2024-03-13 |