| NPI | 1093821340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA DO.000403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH AK9743091) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2016-01-20 |