| NPI | 1659539245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 127859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI lpr00176) |
| 207R00000X Internal Medicine (Licence: RI md12728) | |
| 207R00000X Internal Medicine (Licence: OR md157673) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2024-08-16 |