| NPI | 1588982383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.124405) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.124405) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2023-11-03 |