| NPI | 1396911624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 46801) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.012693) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2014-06-05 |