| NPI | 1093201733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD17677) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.246250) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2026-04-21 |