| NPI | 1598144032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA 34.013552) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.013552) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2022-09-14 |