| NPI | 1497115059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34014644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH SS929978) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2023-12-29 |