| NPI | 1396072948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57017253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME112052) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2022-08-11 |