NPI | 1447468293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8488408-1204) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.001871) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2021-10-21 |