| NPI | 1528580511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC RTL23-0237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.138855) |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2023-06-28 |