| NPI | 1134426398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.010674) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME DO2455) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2019-05-10 |