| NPI | 1417584160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD210011883) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35C.001575) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-07-29 |