| NPI | 1235768813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 100994-875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.031293) |
| 207R00000X Internal Medicine (Licence: OH 34.015431) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2023-08-07 |