| NPI | 1538325642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2011-00586) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35091300) |
| 207R00000X Internal Medicine (Licence: MN 51609) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2021-08-10 |