| NPI | 1477048593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.143105) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8252) |
| Enumeration Date | 2018-07-01 |
| Last Update Date | 2022-11-03 |