NPI | 1104132554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL TRN15225) |
Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: OH 57.022470) |
Enumeration Date | 2010-08-24 |
Last Update Date | 2014-01-09 |