| NPI | 1134104706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-07-2866) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35072866) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2021-09-30 |