| NPI | 1861434433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.077779) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 27311) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2024-01-31 |