| NPI | 1285019174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-21274) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.132801) |
| 207R00000X Internal Medicine (Licence: KS 04-45899) | |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2022-05-12 |