| NPI | 1952096539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.156887) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD600006266) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-08-06 |