| NPI | 1578755476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.144718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME99683) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2023-11-03 |