| NPI | 1538541669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC DO52105) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101021834) |
| 207R00000X Internal Medicine (Licence: OH 34.013445) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-08-17 |