| NPI | 1669932786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.144709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351044589) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2023-04-28 |