| NPI | 1053705020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.131692) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.131692) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-11-27 |