| NPI | 1841257680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD064223L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35080056) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-07-30 |