| NPI | 1164404265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.057551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35057551L) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2022-09-23 |