| NPI | 1437111309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.035304) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: OH 35.035304) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2010-05-23 |