| NPI | 1043231046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q3718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.088018) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2023-06-15 |