| NPI | 1457317737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.074249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036098976) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2011-08-08 |