| NPI | 1538197884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-063967) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-06-3967) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2014-02-24 |