NPI | 1386095560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57.027544) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.132370) |
Enumeration Date | 2016-06-28 |
Last Update Date | 2018-03-05 |