| NPI | 1164468831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34007553s) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34007553S) |
| 174400000X Specialist (Licence: OH 34007553s) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2026-04-07 |