NPI | 1225242878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57.007550) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.007550) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2010-12-23 |