| NPI | 1316105547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2009-00409) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.090795) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2009-12-14 |