| NPI | 1689932717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.141681) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD470537) |
| 207R00000X Internal Medicine (Licence: RI MD15150) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2022-07-14 |