| NPI | 1952797656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME140919) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.026785) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2022-08-10 |