| NPI | 1487733754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C50240) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 37571) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-12-26 |