| NPI | 1871582577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D77012) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35088780) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D77012) | |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2020-12-24 |