| NPI | 1518228121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 4915) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH AP2282058A16) |
| 207R00000X Internal Medicine (Licence: FL OS14402) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2023-05-04 |