| NPI | 1891177127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.142060) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 55304) |
| 207R00000X Internal Medicine (Licence: MO 2015020125) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2021-08-12 |