| NPI | 1376509836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: OH 35.045119) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: OH 35045119M) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2013-02-06 |