| NPI | 1740817287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS024299) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34016469) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-12-29 |