| NPI | 1710909866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01043529A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35068878) |
| 207R00000X Internal Medicine (Licence: ID M-13123) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2017-04-20 |