| NPI | 1932442175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 52743) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01085343A) |
| 207R00000X Internal Medicine (Licence: OH 57.023023) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2021-04-02 |