| NPI | 1598929176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2017-0863) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 127842) |
| 207R00000X Internal Medicine (Licence: MD D0071867) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2021-11-15 |