| NPI | 1538195458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 32157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35060446s) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2024-09-09 |