| NPI | 1205448800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.146327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.249520) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2022-09-28 |