| NPI | 1093754640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02003075A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34008432) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2022-08-05 |