| NPI | 1326027152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.079858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301080844) |
| 208000000X Pediatrics (Licence: OH 35.079858) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2019-07-12 |