| NPI | 1871594077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD449816) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35084666) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 100804) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2020-08-20 |