| NPI | 1134402555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.010124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 2552) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2023-10-08 |