| NPI | 1114994670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35055491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35055491R) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2023-01-20 |