| NPI | 1548883432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57.250098) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 73682) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2024-07-24 |