| NPI | 1326041138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.073760) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35073760N) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2020-12-29 |