| NPI | 1609924984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.093551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 237174) |
| 207R00000X Internal Medicine (Licence: PA MD431273) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-03-23 |