NPI | 1114955283 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35067586B) |
Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: OH 00000000000000000) |
Enumeration Date | 2006-06-29 |
Last Update Date | 2021-09-15 |