NPI | 1679783658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.010753) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.001844) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2023-03-07 |