| NPI | 1740635903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.015151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA DO-05472) |
| 207R00000X Internal Medicine (Licence: IA R-11324) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2023-07-24 |