NPI | 1700803699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.008258) |
Additional Taxonomies | 208D00000X General Practice (Licence: OH 34.008258) |
Enumeration Date | 2006-07-16 |
Last Update Date | 2020-10-26 |