NPI | 1285802314 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: OH 35058959) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-058959) |
Enumeration Date | 2008-02-11 |
Last Update Date | 2022-05-02 |