| NPI | 1689676264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.063586) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35063586) |
| 207R00000X Internal Medicine (Licence: OH 35.063586) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2012-09-05 |