| NPI | 1982680567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.060292) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.060292) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2023-07-21 |