| NPI | 1184676090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101013828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34C.000033) |
| 207R00000X Internal Medicine (Licence: WI 1834-321) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-03-26 |