| NPI | 1225069628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35071758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35071758) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2017-01-13 |