| NPI | 1144351149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.137497) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G81088) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-11-19 |