| NPI | 1952424657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR0058636) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.001782) |
| 207R00000X Internal Medicine (Licence: AR E5527) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2017-05-22 |