| NPI | 1518948785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35085161) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-085161) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2012-12-28 |