| NPI | 1376030049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.141897) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-141897) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2024-06-03 |