| NPI | 1851521496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01086264A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 262588) |
| 207R00000X Internal Medicine (Licence: OH 35.098830) | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2022-02-14 |