| NPI | 1902862774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-054626) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-054626) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-12-13 |