| NPI | 1669635249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34-009783) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.009783) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-01-16 |