| NPI | 1295001204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.150473) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD454257) |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2024-08-02 |