| NPI | 1821068511 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01040891) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35069550) | 
| Enumeration Date | 2006-01-25 | 
| Last Update Date | 2025-07-23 |