| NPI | 1093786857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35 06 7069 P) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35 06 7069 P) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2012-08-24 |