| NPI | 1992084750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: LA 322622) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.121131) |
| 207R00000X Internal Medicine (Licence: LA 322622) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2022-06-30 |