| NPI | 1922254697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.154933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301517181) |
| 207R00000X Internal Medicine (Licence: CA A105208) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2026-06-02 |