| NPI | 1427476258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.130212) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD229479) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2026-07-08 |