| NPI | 1538780440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.154013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301514386) |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2026-07-31 |