| NPI | 1750500070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01067875A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57010131) |
| 208000000X Pediatrics (Licence: IN 01067875A) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2011-09-08 |