| NPI | 1346501319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.128350) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 182733) |
| 207R00000X Internal Medicine (Licence: MI 4301502942) | |
| 207R00000X Internal Medicine (Licence: NC 2015-00597) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2024-08-02 |