| NPI | 1659819928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.013630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TPOS436) |
| 207R00000X Internal Medicine (Licence: VA 0102207507) | |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2022-08-31 |