| NPI | 1528021151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.136298) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E3445) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2026-05-13 |