NPI | 1730504044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35045531) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 21151) |
Enumeration Date | 2014-02-24 |
Last Update Date | 2016-12-13 |