| NPI | 1548296833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-095917) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 39732) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-08-15 |