| NPI | 1811211428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.148982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 14573) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2024-06-23 |