| NPI | 1699734038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-094324) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD427120) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2009-10-29 |