| NPI | 1588845408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 25843) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH BM9528324Q071) |
| 207R00000X Internal Medicine (Licence: OH 35093758) | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2014-07-16 |