| NPI | 1174842884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.145436) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 47262) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 47262) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2022-08-16 |