| NPI | 1649474438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.131133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD439654) |
| 207R00000X Internal Medicine (Licence: CA A120600) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2022-07-21 |