| NPI | 1013117944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01041961A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35042163) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2009-11-24 |