| NPI | 1952492555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35120501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD426718) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA md426718) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2013-02-18 |