| NPI | 1497747877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35087392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 16992) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2023-03-07 |