NPI | 1083176697 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.145238) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.145238) |
Enumeration Date | 2019-04-02 |
Last Update Date | 2023-08-28 |