| NPI | 1881829349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 26179) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.099271) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2021-11-17 |