| NPI | 1417299892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: ME DO3128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD H79462) |
| 207R00000X Internal Medicine (Licence: OH 34.011755) | |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2021-02-24 |