| NPI | 1497064323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 58124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.121355) |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2023-07-20 |