| NPI | 1952570863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS10007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.013703) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2024-03-08 |