| NPI | 1942385802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.051889) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35051889) |
| 207Q00000X Family Medicine (Licence: OH 35-051889) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2023-11-16 |