| NPI | 1154308575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01046045A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.138677) |
| 207R00000X Internal Medicine (Licence: IL 036150622) | |
| 207R00000X Internal Medicine (Licence: MI 4301036005) | |
| 207R00000X Internal Medicine (Licence: TX T2472) | |
| 207R00000X Internal Medicine (Licence: KY 52736) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2024-12-05 |