| NPI | 1891791729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 35.070729) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WV 18557) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD047734L) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2020-05-07 |