| NPI | 1477631869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35043533) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35043533) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35-043533) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-05-15 |