| NPI | 1841452299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 52922) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.092494) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2022-09-22 |