| NPI | 1528394269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.132749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 17589) |
| Enumeration Date | 2009-10-31 |
| Last Update Date | 2021-07-28 |