| NPI | 1437113529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD433152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35083667F) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2021-07-31 |