NPI | 1497053755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.096699) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.206300) |
Enumeration Date | 2011-03-09 |
Last Update Date | 2021-12-17 |