| NPI | 1760431159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35 . 056690) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 31919) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: OH 35 . 056690) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2009-06-18 |