| NPI | 1386683068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01061057) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35079807) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-06-20 |