| NPI | 1376049346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.141679) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301510460) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-10-21 |