| NPI | 1275618803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-08-3669) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C53824) |
| 207R00000X Internal Medicine (Licence: OR MD218769) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-04-04 |