| NPI | 1184053159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.148475) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 23390) |
| 207R00000X Internal Medicine (Licence: NY 281106-1) | |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2024-05-07 |