| NPI | 1952405177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.142859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 15392) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2021-09-27 |