| NPI | 1144740770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD048444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.029866) |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2020-10-27 |