| NPI | 1669632469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.092103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57012346) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2022-04-21 |