NPI | 1245736115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01086944A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-51185) |
207R00000X Internal Medicine (Licence: OH 35.142899) | |
Enumeration Date | 2018-03-31 |
Last Update Date | 2025-06-19 |