| NPI | 1356537716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-096756) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229588) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2021-01-12 |