| NPI | 1881673135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35047668) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-04-9045) |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2011-11-28 |