NPI | 1720406655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.132522) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35132522) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-03-28 |
Last Update Date | 2020-03-28 |