| NPI | 1730136615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35084960) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35.084960) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2011-04-13 |