| NPI | 1538796909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57.249197) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.249197) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-06-25 |