| NPI | 1609009778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.012535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101018332) |
| 208D00000X General Practice (Licence: MI 5101018332) | |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2023-08-07 |