| NPI | 1790827210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 73605-20) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-091988) |
| 207R00000X Internal Medicine (Licence: OH trainee) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2021-07-08 |