| NPI | 1962515924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME107586) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35088092) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 49677) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2021-03-24 |