| NPI | 1720027410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: OH 35-036708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-036708) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-09-18 |