| NPI | 1164654455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.125880) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.125880) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2020-11-20 |