| NPI | 1457343584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35077929M) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35077929) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2010-09-28 |