| NPI | 1992920524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.090326) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35.090326) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-04-26 |