NPI | 1619195427 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A107211) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57012501) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2024-10-30 |