| NPI | 1144602285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101021767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.01426) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-07-24 |