| NPI | 1841873296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.154070) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.251882) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2025-07-30 |