| NPI | 1205844917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35050717) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35050717) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2007-07-23 |