| NPI | 1891321865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.150731) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.150731) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2024-09-24 |