| NPI | 1841574332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.013090) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03226174) |
| 207R00000X Internal Medicine (Licence: OH AP2282058A49) | |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2019-03-01 |