| NPI | 1629432711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 71180) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.135775) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2024-02-20 |