| NPI | 1114022712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35121219) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101240594) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101240594) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-12-24 |