| NPI | 1992732663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.125932) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L9215) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-10-07 |