NPI | 1548341126 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34-4637) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34463700) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2024-10-11 |