| NPI | 1518922350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2024-01021) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.142368) |
| 207R00000X Internal Medicine (Licence: HI 13461) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2024-08-06 |