| NPI | 1952352510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.070698) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-3610) |
| 207R00000X Internal Medicine (Licence: VA 0101245604) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2011-12-23 |