| NPI | 1821659426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.152206) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT219128) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2025-03-03 |