NPI | 1083881486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G21860) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.032356) |
Enumeration Date | 2008-05-14 |
Last Update Date | 2008-05-14 |