| NPI | 1083733273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2008-00518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35085805) |
| 208000000X Pediatrics (Licence: OH 35085805) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2023-04-17 |