| NPI | 1518309616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.134743) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-43552) |
| 207R00000X Internal Medicine (Licence: DC MD045441) | |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2018-08-27 |