| NPI | 1417916651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.057991) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57991) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2023-10-05 |