| NPI | 1982716379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35080950) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 25678) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-03-17 |