| NPI | 1831323393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 75974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.010125) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2023-08-24 |