| NPI | 1427221621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 51408-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.090747) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2023-08-24 |