| NPI | 1811349095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57.028016) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S2261) |
| 207R00000X Internal Medicine (Licence: TX BP10065992) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2023-06-29 |