| NPI | 1679693105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.090238) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 58781) |
| 207R00000X Internal Medicine (Licence: IN 01082775A) | |
| 207R00000X Internal Medicine (Licence: IL 036159098) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2023-06-20 |