| NPI | 1790170595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.130068) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: OH 35.130068) |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: OH 35.130068) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-12-16 |