| NPI | 1114930534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35053183) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101283995) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2024-11-06 |