| NPI | 1831150242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34003858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 3858) |
| 207R00000X Internal Medicine (Licence: PA OS005292L) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2024-01-02 |