| NPI | 1952895716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 34.017886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT018601) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2025-09-10 |