| NPI | 1972574275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35078350) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-07-8350-A) |
| 207R00000X Internal Medicine (Licence: NE 24143) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2008-10-16 |