| NPI | 1144683681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2019-01413) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027835) |
| 207R00000X Internal Medicine (Licence: OH 35.135803) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-02-28 |