| NPI | 1750868246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 75776-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.247560) |
| 207RN0300X Internal Medicine, Nephrology (Licence: WI 75776-20) | |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2024-01-10 |