| NPI | 1205300720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.144584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.144584) |
| 208000000X Pediatrics (Licence: OH 35.144584) | |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2025-03-24 |