NPI | 1316921125 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 26815) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35046574) |
Enumeration Date | 2005-12-05 |
Last Update Date | 2007-07-08 |