| NPI | 1306047154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.094650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 37258) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2021-11-23 |