NPI | 1699126672 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35076235) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301110057) |
Enumeration Date | 2016-06-30 |
Last Update Date | 2019-09-06 |