| NPI | 1891792099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD033648E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 14686) |
| 207R00000X Internal Medicine (Licence: OH 35054409J) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA Md033648E) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 14686) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35054409J) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2012-09-12 |