| NPI | 1174729214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 58.001345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2007-01965) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2008-02-19 |