| NPI | 1871813394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OR MD198344) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-017529) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2021-05-14 |