| NPI | 1962512210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.097215) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N3601) |
| 207R00000X Internal Medicine (Licence: WI 48089) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-08-09 |