| NPI | 1346310174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35062531 A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35062531B) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-02-01 |