| NPI | 1750802278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01086498A) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 57.248799) |
| 207R00000X Internal Medicine (Licence: MI 4301112724) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2025-10-14 |