| NPI | 1770669871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35-06-6707) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-06-6707) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2018-06-15 |