| NPI | 1902002389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD449433) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 50019) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2022-10-12 |