| NPI | 1811154123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A120561) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.097082) |
| 207R00000X Internal Medicine (Licence: CA A120561) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2022-02-11 |