| NPI | 1073560033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 238164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.095884) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2023-07-06 |