| NPI | 1992816888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.143460) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2016-02115) |
| 207R00000X Internal Medicine (Licence: MI 4301071675) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-10-11 |