| NPI | 1649437716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.094624) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 20959) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2021-06-21 |