| NPI | 1053302836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.007166) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.007166) |
| 207R00000X Internal Medicine (Licence: WV 1984) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-07-21 |