| NPI | 1154373975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: OH 35-38382) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-38382) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2015-12-11 |