NPI | 1295001204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.150473) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD454257) |
Enumeration Date | 2012-03-24 |
Last Update Date | 2024-08-02 |