| NPI | 1467485227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35078587K) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301063624) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2013-05-14 |