NPI | 1407054331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.088302) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 37124) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2023-03-07 |