| NPI | 1295716249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35045144b) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.045144) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2019-01-08 |