| NPI | 1023032273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.038293) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.038293) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.038293) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-08-15 |